Vatin L, Morvan J-B, Rivière D, Okremchouk I, Abed S, Verdalle P
Rev Laryngol Otol Rhinol (Bord). 2015;136(1):9-15.
To describe 18 cases of patients treated for advanced cutaneous squamous cell carcinoma (CSCC) of the head metastasing to cervical lymph nodes and parotid gland. To estimate their survival and the risk factors of metastases.
18 cases of patients affected by CSCC of the head, metastatic to parotid and cervical lymph nodes were afterward analyzed. Two populations were differentiated: the patients already treated for their CSCC, with secondary appearance of metastases in the Population A, the patients by whom the metastase is concomitantly discovered to the CSCC in the Population B.
The treatment consisted of a parotidectomy and neck dissection, possibly associated with excision of the primary tumour. Adjuvant radiotherapy was systematic. Metastatic progression was on lungs most of the time (57%), in patients of the population B (80%), or of whom primitive CSCC was of bad forecast (group 2) (78%). The mortality was bound to the complications induced by distant metastases (63%), at 5 years it was superior in the population B (100%) than in the population A (77%).
CSCC of the head, metastatic to parotid and cervical lymph nodes have a severe prognosis for survival in spite of an optimal curative treatment applied to fragile old patients.
描述18例头部晚期皮肤鳞状细胞癌(CSCC)转移至颈部淋巴结和腮腺的患者。评估其生存率及转移的危险因素。
对18例头部CSCC转移至腮腺和颈部淋巴结的患者进行分析。区分出两组人群:A组为已接受CSCC治疗后出现转移的患者,B组为CSCC同时伴有转移的患者。
治疗包括腮腺切除术和颈部淋巴结清扫术,可能联合原发肿瘤切除术。辅助放疗是常规操作。转移进展多数发生在肺部(57%),B组患者(80%)或原发CSCC预后不良的患者(2组)(78%)中更为常见。死亡率与远处转移引起的并发症相关(63%),5年时B组(100%)高于A组(77%)。
尽管对身体状况不佳的老年患者采用了最佳的根治性治疗,但头部CSCC转移至腮腺和颈部淋巴结的患者生存预后仍较差。